|lipo and Reyataz
Jul 30, 2003
Is there any clinical evidence that the combination of Reyataz/ Viread/ Epivir has less lipoatrophy effects that Viracept/Epivir/ Zerit?
Response from Dr. Moyle
Simple answer to this is yes. In a large AIDS clinical trials group study (ACTG. 384) the combination of d4T and nelfinavir was associated with a significantly faster rate of fat loss and combinations that contained either efavirenz instead of nelfinavir, and AZT instead of d4T. In a Gilead study (903) individuals taking either tenofovir or d4T in combination with 3 TC and efavirenz the development of lipodystrophy (as defined by the study investigator) was more common in individuals receiving d4T. Recent results looking at scans of individuals treated for 48 weeks with either Combivir plus atazanavir or Combivir plus efavirenz saw no differences in the changes in fat mass between the two treatment approaches. Overall, both groups gained a little fat over 48 weeks. The best guess based on these results would be that atazanavir may be more benign than other protease inhibitors in contributing to lipodystrophy and that tenofovir and AZT are associated with slower fat loss over time compared with d4T.
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